Healthcare Provider Details

I. General information

NPI: 1790812147
Provider Name (Legal Business Name): ARBORVIEW PSYCHOLOGICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 01/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16152 BEACH BLVD SUITE 179
HUNTINGTON BEACH CA
92647
US

IV. Provider business mailing address

PO BOX 10313
WESTMINSTER CA
92685
US

V. Phone/Fax

Practice location:
  • Phone: 714-841-1330
  • Fax: 714-841-1316
Mailing address:
  • Phone: 714-841-1330
  • Fax: 714-841-1316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY16356
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC20709
License Number StateCA

VIII. Authorized Official

Name: DR. MARICHU CARRION WOLMERATH
Title or Position: OWNER
Credential: PHD
Phone: 714-841-1330